Provider Demographics
NPI:1932790987
Name:POTRANCO FAMILY DENTAL PLLC
Entity Type:Organization
Organization Name:POTRANCO FAMILY DENTAL PLLC
Other - Org Name:POTRANCO FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUMEET
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-913-2151
Mailing Address - Street 1:224 HIGHWAY 290 W
Mailing Address - Street 2:
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77833-9166
Mailing Address - Country:US
Mailing Address - Phone:617-955-6017
Mailing Address - Fax:979-830-5004
Practice Address - Street 1:14317 POTRANCO ROAD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245
Practice Address - Country:US
Practice Address - Phone:213-290-8160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty